变革型代理与知识管理中的紧张关系——一项针对护理领导者的定性访谈研究。
Transformative agency and tensions in knowledge management-A qualitative interview study for nurse leaders.
机构信息
Department of Social Services and Health Care, City of Helsinki, Helsinki, Finland.
Department of Nursing Science, University of Eastern Finland, Kuopio, Finland.
出版信息
J Clin Nurs. 2019 Mar;28(5-6):969-979. doi: 10.1111/jocn.14694. Epub 2018 Nov 8.
AIM
To describe Finnish nurse leaders' perceptions of and experiences with knowledge management.
BACKGROUND
Health science research has traditionally focused on knowledge transfer and research evidence instead of knowledge management, culture and organisational learning. Systematic reviews indicate a lack of awareness about nurse leaders' activities in knowledge management.
DESIGN
Qualitative interview study according to the consolidated criteria for reporting qualitative research (see Supporting Information Table S1).
METHODS
Data were collected at a Finnish public, social and healthcare organisation from 33 persons in 2015 and 2017 through 35 individual interviews and seven focus groups. Data were analysed by thematic analysis.
RESULTS
Nurse leaders' daily knowledge management activities included assurance of smooth work functions and decisions about sudden changes. When managing knowledge promotion, nurse leaders focused on the near future and served information providers, coaches and developers of operating culture. Anticipatory management of knowledge requirements emphasised nurse leaders' roles as assessors and visionaries. Tensions while managing knowledge were related to the following: changes in clients' service needs, insufficient structures and tools to support the assessment and joint development of competence, time and information management, the operating culture, and nurse leader support. Participants reported only few attempts to solve tensions and therefore little to no transformative agency.
CONCLUSION
Nurse leaders prioritised daily knowledge management over management of knowledge promotion and anticipatory management of knowledge requirements. Knowledge management in nursing is a complex task requiring a command of different kinds of agency and related leadership styles. The structures, processes and tools supporting knowledge management should be developed to ensure that activities are systematic.
RELEVANCE TO CLINICAL PRACTICE
A description of nurse leaders' perceptions of and experiences with knowledge management could improve recognition of nurse leaders' agencies for knowledge management, identification of related tensions and application of lessons learned from tensions. This description could also promote nurses' professional competence and supplement nurse leaders' training.
目的
描述芬兰护理领导者对知识管理的认知和经验。
背景
健康科学研究传统上侧重于知识转移和研究证据，而不是知识管理、文化和组织学习。系统评价表明，人们对护理领导者在知识管理中的活动缺乏认识。
设计
根据定性研究报告的统一标准（见表 S1）进行定性访谈研究。
方法
2015 年至 2017 年，在芬兰一家公共、社会和医疗机构，通过 35 次个人访谈和 7 次焦点小组，从 33 名参与者处收集数据。通过主题分析对数据进行分析。
结果
护理领导者的日常知识管理活动包括确保工作职能的顺利进行和对突发事件的决策。在管理知识推广时，护理领导者关注近期情况，为信息提供者、教练和运营文化的开发者提供服务。对知识需求的前瞻性管理强调了护理领导者作为评估者和有远见者的角色。管理知识需求时的紧张关系与以下方面有关：客户服务需求的变化、支持评估和共同发展能力、时间和信息管理、运营文化以及护理领导者支持的结构和工具不足。参与者报告说，他们很少试图解决紧张关系，因此几乎没有变革代理。
结论
护理领导者将日常知识管理置于知识推广管理和知识需求前瞻性管理之上。护理中的知识管理是一项复杂的任务，需要掌握不同类型的代理和相关的领导风格。应开发支持知识管理的结构、流程和工具，以确保活动的系统性。
临床相关性
描述护理领导者对知识管理的认知和经验，可以提高对护理领导者知识管理代理的认识，识别相关紧张关系，并应用从紧张关系中吸取的经验教训。这种描述还可以促进护士的专业能力，并补充护理领导者的培训。
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